Basic Information
| Provider Information | |||||||||
| NPI: | 1982079620 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 S ZEDIKER AVE | ||||||||
| Address2: | BLDG 3 | ||||||||
| City: | PARLIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936482666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596466618 | ||||||||
| FaxNumber: | 5598766705 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FOWLER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936252433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596466618 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2015 | ||||||||
| LastUpdateDate: | 12/07/2015 | ||||||||
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| AuthorizedOfficialLastName: | CURTIS | ||||||||
| AuthorizedOfficialFirstName: | COLLEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5596466618 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.